U.S.

FDA Cosmetic registration is an FDA post-market reporting system for use by manufacturers,
packers, and distributors of cosmetic products that are in commercial distribution in the US. There are
two parts in FDA Voluntary Cosmetic Registration Program. Voluntary Cosmetic Establishments
Registration and Cosmetic Product Ingredient Statements (CPIS) Filing.
The State of California has imposed additional requirements for cosmetic products intended for use in
California.
Qpro Regulatory Services are always happy to assist you. Complete the following questionnaire which
is self explanatory. Please feel free to contact us if you have any queries.
FDA VOLUNTARY COSMETIC REGISTRATION PROGRAM
U.S. FDA Voluntary Cosmetic Registration Program is Post-market reporting system. A company can
participate in Voluntary Cosmetic Registration Program only if their products are in commercial
distribution in USA.

Whether your company products are in commercial distribution in USA?

Yes
No
If Yes, please provide Products names that are in commercial distribution in USA.
Product Names: _______________________________________________________________
CALIFORNIA SAFE COSMETICS PROGRAM (CSCP)
California Safe Cosmetics Program reporting is required if the products are sold in California and the
product ingredients contain any level (concentration) of a chemical known or suspected to cause cancer or
reproductive harm.

Whether your cosmetic products are sold in California?

Yes
No
Do your products contain an ingredient known or suspected by an authoritative scientific body
cited in the California Safe Cosmetics Act of 2005 (the Act) to cause cancer or reproductive harm?
Yes
No
If Yes, please provide Products names that are in commercial distribution in USA.
Ingredients or Chemical Names:___________________________________________________
Comments (If any): ___________________________________________________________________
By: ________________________________________________

Date: _ _ - _ _ - 201_

Signature

qproregulatoryservices@gmail.com

www.usfdacosmetics.net

Voluntary Cosmetic Establishments Registration Form

INSTRUCTIONS
Type entries in CAPITAL LETTERS.
If you have more than one location, each location should register separately.
Complete a separate Form for each Establishment Location.
Use standard abbreviations whenever necessary. Omit all punctuation.
If you need Cosmetic Product Ingredient Statements (CPIS) Filing Form, California Safe
Cosmetics Program (CSCP) Form or any other forms, please download from our website or
contact us.
TYPE OF SUBMISSION
Original

Amendment

Cancellation

FDA registration number (for Amendment / Cancellation): ________________________________

COMPANY INFORMATION
Establishment Name: ______________________________________________________________
(Please include Business Entity eg. Ltd., Inc., etc, if any)

Business Type:

Manufacturer

Packer

Both

Others: ______________________

Name of Parent Company (if any): ___________________________________________________

(Please include Business Entity eg. Ltd., Inc., etc, if any)

Street Address: _________________________________________________________________

City: ____________________ State/Province: _____________________ ZIP/Pincode: ________
Country: ______________________________ Website: _________________________________
CONTACT INFORMATION
Contact Name: ______________________/______________________/______________________
First Name

Middle Name

Last Name

Designation: ____________________________ Email: __________________________________

Telephone: _____________________________ Fax: ___________________________________

qproregulatoryservices@gmail.com

www.usfdacosmetics.net

DOING BUSINESS AS
Sl. No

Other Business Trading Names (Doing Business As)

Type of Action

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.

PAYMENT INFORMATION
PayPal Transaction Number (ID): ___________________________________________________
Date of Payment: _ _ - _ _ - 201__
{Please contact us for Payment related queries or any other information. We are always happy to assist you.}

Comments (If any): ___________________________________________________________________

qproregulatoryservices@gmail.com

www.usfdacosmetics.net

AGREEMENT
Qpro Regulatory Services and the undersigned party have today entered into an agreement
regarding the provision of consultancy services on the terms and conditions laid out in this
Agreement.

In rendering consulting services under this Agreement, Qpro Regulatory Services shall conform
to standards of work and business ethics. However, Qpro Regulatory Services shall bear no
liability or otherwise be responsible for complete assurance and delays in the provision of
Services.

The Client agrees to provide accurate and sufficient information, adequate technical assistance
and documentation, required for Qpro Regulatory Services to be able to perform the Services.
The Client shall promptly provide further information Qpro Regulatory Services reasonably
deems relevant to perform the task.

The Client is solely responsible for the scientific accuracy, material facts and completeness of
information provided to Qpro Regulatory Services.

The Client shall pay to Qpro Regulatory Services fees at the rate specified in the Purchase
Order.

The Parties agree to make all reasonable efforts, in good faith, to resolve any dispute arising
from implementation of this agreement through informal discussions and the development of
mutual satisfactory options.

Qpro Regulatory Services liability in whatever kind or nature cannot exceed the fee for
performing the task.

This Agreement shall terminate automatically upon completion by Qpro Regulatory Services of
the Services required by this Agreement or 30 calendar days from the effective date of this
agreement.

Qpro Regulatory Services is a Private business entity and is not affiliated with U.S. FDA.

By: _______________________________ Company Name: ________________________________

Signature
_______________________________________________________________________________
Authorized Person Name
_______________________________________________________________________________
Designation
Date: _ _ - _ _ - 201_

___________________________________________________________

qproregulatoryservices@gmail.com

www.usfdacosmetics.net